Provider Demographics
NPI:1841490968
Name:BODENSTEIN, FAYE (ACSW)
Entity type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:
Last Name:BODENSTEIN
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PITCHING WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2911
Mailing Address - Country:US
Mailing Address - Phone:908-889-0688
Mailing Address - Fax:908-889-0688
Practice Address - Street 1:15 BRANT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1564
Practice Address - Country:US
Practice Address - Phone:908-930-3069
Practice Address - Fax:908-889-0688
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007538001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical